Moving a client from a telephone call onto a telemedicine app

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Veterinarians are very good at offering telemedicine over the telephone. We provide our clients with excellent customer care and our patients get help remotely. The greatest drawback to telemedicine via the telephone is the difficulty in monetizing the experience. The attached video demonstrates how our reception team moves a telephone call onto Medici (telemedicine app). The result is a happy client and a healthy patient.

Remote care is better for for cases

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This cat presented for limping. As you watched the first part of the short video, you see the cat reluctant to move in the exam room.

I was unable to appreciate a consistent limp in the exam room. I asked the owner to send a video from home.

The second part of the video reveals an obvious limp when the cat was comfortable at home.

I am excited to see more cats get diagnosed with arthritis earlier in the disease process so that they can get pain relief and a better quality of life.

You’re worth it

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Most veterinarians are highly skilled at telemedicine but we don’t typically give our clients the opportunity to pay for remote care.  Before I started to offer paid telemedicine, I was worried that my clients would bristle at the concept.  To my surprise, clients not only accepted paid telemedicine, but typically thanked me after I charged them for the service.

I’ve been wondering why I was slow to introduce paid telemedicine.  The obvious answer is that I was worried clients would be upset about the cost, but the root cause of my delay was that I didn’t think my professional opinion was worth it.  

Veterinarians, myself included, tend to undervalue our professional knowledge.  We are comfortable monetizing our surgical skills, vaccinations and pharmaceuticals, but when it comes to our professional opinion we find it difficult to justify a fee.

My hope is that the dialogue around veterinary telemedicine pivots from a technical conversation on how to offer telemedicine into a conversation about worth.  Once we as a community encourage each other to value our professional expertise, paid telemedicine will become much easier to implement.  

Busting 4 myths of veterinary telemedicine: Why clients are willing to pay

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Veterinarians have offered telemedicine for over 100 years. We consult on the phone, answer emails, and exchange text messages with our clients about their animals every day. Through telemedicine we have been able to meet the increasing expectations of convenience, access and immediacy from our clients, but veterinarians have struggled to monetize this service.  Thankfully, clients are willing to pay for telemedicine and this technology now provides a seamless platform to exchange money. Momentum behind telehealth has been growing as the American Veterinary Medical Association (AVMA) encourages veterinarians to explore the possibilities of telemedicine. Like a lot of veterinarians, I had concerns about charging clients for telemedicine, including liability, client acceptance and reimbursement. I soon realized, however, that telemedicine conducted inside the right technology actually reduces liability, improves the veterinary-client-patient-relationship (VCPR) and creates a new revenue stream. Below are four persistent myths preventing widespread adoption of paid telemedicine.

Myth #1: Telemedicine increases liability

Telemedicine inside of a secure technology reduces liability in three ways. First, a picture or video is worth a thousand words.  A veterinarian who only offers telemedicine via a telephone has to rely on the owner to accurately describe the problem. If, on the other hand, the veterinarian can obtain a picture or a video of the same problem, he or she can now form a more independent and accurate opinion, resulting in a better medical decision for her patient.  

Second, a conversation about a patient with a client requires documentation in the medical record.  When I previously used SMS text messaging to communicate with clients, I did not always get the conversations into the medical record because it was difficult to export. At that time, I wasn’t always compliant with state requirements for veterinary medical records. Now I use a platform that will easily export the entire conversation to be preserved in the medical record.   

Third, telemedicine platforms offer liability insurance in addition to your existing malpractice insurance. I use a platform that provides $1 million in malpractice insurance.  It is more than I need but I am glad to have the peace of mind.  

Myth #2: Veterinary telehealth will not generate revenue 

Since I began offering fee-based telemedicine via Medici, I have generated an additional 2% in revenue per month. I believe this number will continue to grow as clients become more aware of the service. Approximately 60% of our clients that engage with fee-based telemedicine on Medici use the service again within 12 months. This is a strong signal that clients like the service. The only additional cost is the subscription fee because the owner is paying for my professional service. Eventually, my goal is to handle all simple cases via telemedicine, with the potential to use virtual care on up to 30% of my cases. By seeing more patients remotely, I’ll have a greater amount of time to spend on more complex cases and wellness exams that require in-office visits.

Myth #3: Clients will not pay for virtual care

This myth is deeply embedded in the veterinary profession because we have offered free telemedicine for more than 100 years, but it is not true. I have found that clients are willing to pay for telemedicine if two requirements are met: First, free telemedicine is offered with veterinary technicians and second, the cost of telemedicine is less than an in-clinic exam.  Clients appreciate the lower cost and convenience of telemedicine. Dr. Matthew Salois, AVMA chief economist, reports that pet owners do not seek veterinary care due to cost. Even 20% of clients who earn income of more than $100,000 annually are concerned about the cost of veterinary care. When we explain fee-based telemedicine to our clients as being characterized by “more convenience and less expense,” most are eager to try it. 

Myth #4: Virtual care will ruin my work-life balance

Fee-based telemedicine has reduced my workload and allowed me to work from home on Saturday mornings. The time I would otherwise spend calling owners back is streamlined with texting through Medici. As a result, I don’t have to play phone tag and almost all my consults occur during the work week. Initially, I was worried that I would get messages all hours of the day and night but after approximately 1,700 cases, I have found that clients do not send messages in the middle of the night. 

I attribute the lack of calls during the night to four factors. First, I can turn Medici off.  Second, people are more respectful of me when there is a value placed on the interaction.  Third, if the animal is having an emergency that requires immediate in-person care, the client takes the animal to the ER clinic. Fourth, I am interacting with VCPR-compliant cases. These are people who know me and choose me to care for their pets.  

After handling a telemedicine case, the most common response I get from clients when I let them know that I am going to charge them for the visit is “Thank you!”